Agoraphobia is the fear of being in places where help may not be available. It usually involves fear of crowds, bridges, or of being outside alone. Typical symptoms include severe anxiety, dependence on others, fear of being alone, and the fear of losing control in public. Though someone severely agoraphobic may have a hard time leaving their house, there are levels with a lesser intensity where people can function normally. Regardless, there are two factors that do not typically change: fear of feeling trapped in a difficult situation, and the fear of feeling trapped. So someone who may not display the obvious symptoms of losing control at the thought of doing difficult things may actually be thinking frantically to find a way out of the hard situation. Also important in recognizing someone who may be agoraphobic is their need to be in control. Anxiety begins when they feel as though they are losing control, so their demeanor may grow harsh if they begin to feel as though they are no longer managing the situation.

Dr. Paul Foxman, founder and director of the Center for Anxiety Disorders in Vermont says that “Agoraphobia is a learned condition that develops over time, usually resulting from having an anxiety experience in a particular situation. Thereafter, that and similar situations are associated with anxiety and avoided.” Traumatic events such as deaths or car accidents can lead to stress levels rising any time one may be in a situation that can result in the same way. In this way not everyone shows the same symptoms or has the same triggers; it is based entirely off the event that led them to become agoraphobic.

The process to revive one’s confidence in the situations they are so afraid of is called exposure therapy. Dr. Foxman notes that “Exposure therapy works best when the person has first practiced anxiety control skills, such as the ability to calm oneself at the first sign of anxiety. Only when equipped with such skills can the person hope to have a positive outcome when ‘exposed’ to the feared situation.” These practiced anxiety control skills are common practices people use to coach them through particularly stressful situations. Many people use the “HA” breath method which allows them to regain control by slowing down their breathing. Not surprisingly, many people even without Agoraphobia use some of the methods to calm themselves. Counting to or backwards from ten, or tapping to refocus the mind on an activity.

Once these steps have been mastered, exposure therapy can begin. Dr. Foxman clarifies that this exposure process can take time to accomplish. “The time period depends on how entrenched the avoidant pattern is. It is a good idea to make a list of all the avoided or feared situations and then rank order them in order of difficulty. Then, using ‘visualization,’ imagine yourself going through the situation while relaxed. Continue until you can do the whole situation without anxiety. Then try in real life, using small steps. This could take weeks or months.” This process of exposure therapy is written seamlessly in Tom Stoppard’s adaptation of Heroes.

Gustave, a veteran of WWI, is stricken with Agoraphobia. Ever since he arrived at the Veteran’s retirement home six months previous he has been afraid to leave the safety of the building. He spends every day on a terrace overlooking fields of poppies, and never ventures into town. Throughout the play Gustave battles his phobia and practices this exposure therapy when Henri reminds him that the last time he tried to leave he was “found by the gate curled up into a ball and whimpering like a baby.” Gustave proceeds to prepare for his departure by practicing walking out the door. This behavior is a form of the “visualization” Dr. Foxman speaks of. Gustave practicing walking out the door and imagining it is his way of calming himself; he is training his mind to believe that he will be safe.

Watch closely to see if you can notice any other signs of Agoraphobia in Tom Stoppard’s adaptation of Heroes.